Is Level of injury a determinant of quality of life among individuals with spinal cord injury? a tertiary rehabilitation center report

Objectives: The role of injury-related variables in determining health-related quality of life [HRQOL] among Iranian persons with spinal cord injury [SCI] has not yet been fully described. In this study, we compared HRQOL between individuals with injury at cervical level and those with injury at thoracolumbar sections and evaluated the discriminating value of injury level as a determinant of HRQOL among Iranian people with SCI

Methods: Individuals with SCI, who were referred to Brain and Spinal Cord Injury Research Center, were invited to participate in this investigation. HRQOL was assessed using the Short Form [SF-36] questionnaire to determine the quality of life [QOL] in eight domains: physical functioning [PF], role limitation due to physical problems [RP], bodily pain [BP], general health [GH], vitality [VT], social functioning [SF], role limitation due to emotional problems [RE], and mental health [MH]

Results: Ninety patients with paraplegia and 94 quadriplegic patients participated in this investigation. The mean score of PF domain was significantly lower in patients with injury at cervical level [p < 0.0001]. There was no significant difference in other domains of SF-36 between subjects with paraplegia and quadriplegia [p = 0.670, 0.700, 0.910, 0.710, 0.730, 0.290 and 0.850 for RP, RE, VT, MH, SF, BP and GH, respectively]. Similarly, the mean physical component summary [PCS] score was significantly higher among individuals with injury at thoracolumbar sections [p < 0.0001]. The mean mental component summary [MCS] score did not differ between the two groups [p = 0.720]

Conclusions: Patients with SCI at the cervical level have similar mental health compared to those with injury at thoracolumbar sections, which shows proper mental adaptability in quadriplegic individuals. Injury level can be used as a major determinant of the physical component of QOL among people with SCI

relationship between dietary intakes of amino acids and bone mineral density among individuals with spinal cord injury

Objectives: The effect of dietary protein intake on bone mineral density [BMD] has not been explained in patients with spinal cord injury [SCI]. In this study, we looked at the relationship between BMD and higher protein intake in patients with SCI while controlling for possible confounders

Methods: Patients with SCI, who were referred to the Brain and Spinal Cord Injury Research Center between November 2010 and April 2012, were included in the study. In total, the dietary intakes of 103 patients were assessed by 24-hour dietary recall interviews. We used dual-energy X-ray absorptiometry to measure BMD in the femoral neck, trochanter, intertrochanteric zone, hip, and lumbar vertebras

Results: Eighty-six men and 17 women participated in this study. Protein intake was negatively associated with the BMD of lumbar vertebrae [p = 0.001, r = -0.37 for T-score and p = 0.030, r = -0.24 for Z-score]. The BMD of lumbar vertebrae were negatively associated with intake of tryptophan, isoleucine, lysine, cysteine, and tyrosine [p = 0.007, 0.005, 0.009, 0.008, and 0.008 for T-score, respectively]. Higher intakes of threonine, leucine, methionine, phenylalanine, valine, and histidine were related to a lower BMD of lumbar vertebrae [p = 0.006, 0.010, 0.009, 0.010, 0.009, and 0.008 respectively for T-scores]

Conclusions: We found that high protein intake led to a lower BMD of lumbar vertebrae in patients with SCI after controlling for confounders including demographic and injury-related characteristics and calcium intake. No relationship between higher amino acids intake and BMD of the femur and hip was detected. Intake of alanine, arginine, and aspartic acid were not related to BMD